Initial Experience in Total Laparoscopic Central Pancreatectomy with Pancreatogastrostomy
- 142 Downloads
- 1 Citations
Abstract
Central pancreatectomy is an ideal treatment option to preserve pancreatic parenchyma and function for the benign and low-grade malignant tumors limited to the pancreatic neck or proximal body of the pancreas. This study presents our initial experience in total laparoscopic central pancreatectomy with pancreatogastrostomy. In 2013, two consecutive patients underwent total laparoscopic central pancreatectomy at our hospital. Data on surgical procedure, post-operative course, and follow-up were evaluated. Both the patients successfully underwent total laparoscopic central pancreatectomy with pancreatogastrostomy. The operating times were 250 and 300 min with blood loss of 100 and 200 ml and post-operative hospital stay of 9 and 10 days, respectively. The first patient did not suffer any post-operative complications. The second patient developed intra-abdominal fluid collection due to pancreatic fistula which was managed by percutaneous drainage. These two patients had no post-operative diabetes mellitus or exocrine insufficiency within the follow-up periods of 14 and 10 months, respectively. Thus, laparoscopic CP is a safe and feasible technique for treating benign and low-grade malignant tumors in the neck or proximal body of the pancreas when performed by highly skilled pancreatic and laparoscopic surgeons.
Keywords
Central pancreatectomy Laparoscopy PancreatogastrostomyReferences
- 1.Barens, S. A., Lillemoe, K. D., Kaufman, H. S., Sauter, P. K., Yeo, C. J., Talamini, M. A., et al. (1996). Pancreaticoduodenectomy for benign disease. American Journal of Surgery, 171, 131–135.PubMedCrossRefGoogle Scholar
- 2.Yeo, C. J., Wang, B. H., Anthone, G. J., & Cameron, J. L. (1993). Surgical experience with pancreatic islet-cell tumors. Archives of Surgery, 128, 1143–1148.PubMedCrossRefGoogle Scholar
- 3.Sperti, C., Pasquali, C., Ferronato, A., & Pedrazzoli, S. (2000). Medial pancreatectomy for tumors of the neck and body of the pancreas. Journal of the American College of Surgeons, 190, 711–716.PubMedCrossRefGoogle Scholar
- 4.Aldridge, M. C., & Williamson, R. C. N. (1991). Distal pancreatectomy with and without splenectomy. British Journal of Surgery, 78, 976–979.PubMedCrossRefGoogle Scholar
- 5.Miedema, B. W., Sarr, M. G., van Heerden, J. A., Nagorney, D. M., McIlrath, D. C., & Ilstrup, D. (1992). Complications following pancreaticoduodenectomy: Current management. Archives of Surgery, 127, 945–950.PubMedCrossRefGoogle Scholar
- 6.Cameron, J. L., Pitt, H. A., Yeo, C. J., Lillemoe, K. D., Kaufman, H. S., & Coleman, J. (1993). One hundred and forty-five pancreaticoduodenectomies without mortality. Annals of Surgery, 217, 430–438.PubMedCentralPubMedCrossRefGoogle Scholar
- 7.Dagradi, A., & Serio, G. (1984). Pancreatectomia intermedia. In: Enciclopedia Medical Italiana, Pancreas, vol XI. (pp. 850–851). Florence: USES Ed. Scientifiche.Google Scholar
- 8.Celis, J., Berrospi, F., Ruiz, E., Payet, E., & Luque, C. (2001). Central pancreatectomy for tumors of the neck and body of the pancreas. Journal of Surgical Oncology, 77, 132–135.PubMedCrossRefGoogle Scholar
- 9.McLeod, R. S., Taylor, B. R., O’Connor, B. I., Greenberg, G. R., Jeejeebhoy, K. N., Royall, D., et al. (1995). Quality of life, nutritional status, and gastrointestinal hormone profile following the Whipple procedure. American Journal of Surgery, 169, 179–185.PubMedCrossRefGoogle Scholar
- 10.Matsumoto, H., Miwa, K., Tsugawa, K., Segawa, M., Fushida, S., Yonemura, Y., et al. (1993). Evaluation regarding effect and quality of life after distal pancreatectomy combining total gastrectomy. Nippon Geka Gakkai Zasshi, 94, 1244–1248.PubMedGoogle Scholar
- 11.Letton, A. H., & Wilson, J. P. (1959). Traumatic severance of pancreas treated by Roux-en-Y anastomosis. Surgery Gynecology Obstetrics, 109, 474–478.Google Scholar
- 12.Ito, K. (2005). Duodenum preservation in pancreatic head resection to maintain pancreatic exocrine function (determined by pancreatic function diagnostant test and cholecystokinin secretion). Journal of hepato-biliary-pancreatic surgery, 12, 123–128.PubMedCrossRefGoogle Scholar
- 13.Scatton, O., Sauvanet, A., Cazals-Hatem, D., Vullierme, M. P., Ruszniewski, P., & Belghiti, J. (2006). Dorsal pancreatectomy: An embryology-based resection. Journal of Gastrointestinal Surgery, 10, 434–438.PubMedCrossRefGoogle Scholar
- 14.Mabrut, J. Y., Fernandez-Cruz, L., Azagra, J. S., Bassi, C., Delvaux, G., Weerts, J., et al. (2005). Laparoscopic pancreatic resection: Results of a multicenter european study of 127 patients. Surgery, 137, 597–605.PubMedCrossRefGoogle Scholar
- 15.Shimizu, S., Tanaka, M., Konomi, H., Mizumoto, K., & Yamaguchi, K. (2004). Laparoscopic pancreatic surgery: Current indications and surgical results. Surgical Endoscopy, 18, 402–406.PubMedCrossRefGoogle Scholar
- 16.Fernandez-Cruz, L., Martinez, I., Gilabert, R., Cesar-Borges, G., Astudillo, E., & Navarro, S. (2004). Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasms of the pancreas. Journal of Gastrointestinal Surgery, 8, 493–501.PubMedCrossRefGoogle Scholar
- 17.Tagaya, N., Kasama, K., Suzuki, N., Taketsuka, S., Horie, K., Furihata, M., et al. (2003). Laparoscopic resection of the pancreas and review of the literature. Surgical Endoscopy, 17, 201–206.PubMedCrossRefGoogle Scholar
- 18.Ammori, B. J. (2003). Pancreatic surgery in the laparoscopic era. Journal of the Pancreas, 4, 187–192.PubMedGoogle Scholar
- 19.Su, C. H., Shyr, Y. M., Lui, W. Y., & P’Eng, F. K. (2004). Surgical treatment for serous cystadenoma of pancreas—Segmental pancreatectomy or conventional resection? Hepato-Gastroenterology, 51, 595–598.PubMedGoogle Scholar
- 20.Baca, I., & Bokan, I. (2003). Laparoscopic segmental pancreas resection and pancreatic cystadenoma. Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 74, 961–965.PubMedCrossRefGoogle Scholar
- 21.Machado, M. A., Surjan, R. C., Epstein, M. G., & Makdissi, F. F. (2013). Laparoscopic central pancreatectomy: A review of 51 cases. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 23, 486–490.CrossRefGoogle Scholar
- 22.Schlitt, H. J., Schmidt, U., Simunec, D., Jager, M., Aselmann, H., Neipp, M., et al. (2002). Morbidity and mortality associated with pancreatogastrostomy and pancreatojejunostomy following partial pancreatoduodenectomy. The British Journal of Surgery, 89, 1245–1251.PubMedCrossRefGoogle Scholar
- 23.Takano, S., Ito, Y., Watanabe, Y., Yokoyama, T., Kubota, N., & Iwai, S. (2000). Pancreaticojejunostomy versus pancreaticogastrostomy in reconstruction following pancreaticoduodenectomy. The British Journal of Surgery, 87, 423–427.PubMedCrossRefGoogle Scholar
- 24.Poon, R. T., Lo, S. H., Fong, D., Fan, S. T., & Wong, J. (2002). Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy. American Journal of Surgery, 183, 42–52.PubMedCrossRefGoogle Scholar
- 25.Sucandy, I., Pfeifer, C. C., & Sheldon, D. G. (2010). Laparoscopic assisted central pancreatectomy with pancreaticogastrostomy reconstruction—An alternative surgical technique for central pancreatic mass resection. North American Journal of Medical Sciences, 2, 438–441.PubMedCentralPubMedCrossRefGoogle Scholar
- 26.Sa Cunha, A., Rault, A., Beau, C., Collet, D., & Masson, B. (2007). Laparoscopic central pancreatectomy: Single institution experience of 6 patients. Surgery, 142, 405–409.PubMedCrossRefGoogle Scholar
- 27.Rotellar, F., Pardo, F., Montiel, C., Benito, A., Regueira, F. M., Poveda, I., et al. (2008). Totally laparoscopic roux-en-y duct-to-mucosa pancreaticojejunostomy after middle pancreatectomy: A consecutive nine-case sreies at a single institution. Annals of Surgery, 247, 938–944.PubMedCrossRefGoogle Scholar
- 28.Aranha, G. V., & Shoup, M. (2005). Nonstandard pancreatic resections for unusual lesions. American Journal of Surgery, 189, 223–228.PubMedCrossRefGoogle Scholar
- 29.Roggin, K. K., Rudloff, U., Blumgart, L. H., & Brennan, M. F. (2006). Central pancreatectomy revisited. Journal of Gastrointestinal Surgery, 10, 804–812.PubMedCrossRefGoogle Scholar
- 30.Sugiyama, M., Abe, N., Ueki, H., Masaki, T., Mori, T., & Atomi, Y. (2004). Pancreaticogastrostomy for reconstruction after medial pancreatectomy. Journal of the American College of Surgeons, 199, 163–165.PubMedCrossRefGoogle Scholar
- 31.Pratt, W., Maithel, S. K., Vanounou, T., Callery, M. P., & Vollmer, C. M, Jr. (2006). Postoperative pancreatic fistulas are not equivalent after proximal, distal, and central pancreatectomy. Journal of Gastrointestinal Surgery, 10, 1264–1278.PubMedCrossRefGoogle Scholar
- 32.Goldstein, M. J., Toman, J., & Chabot, J. A. (2004). Pancreaticogastrostomy: A novel application after central pancreatectomy. Journal of the American College of Surgery, 198, 871–876.CrossRefGoogle Scholar
- 33.Warshaw, A. L., Rattner, D. W., Fernandez-del Castillo, C., & Z’Graggen, K. (1998). Middle segment pancreatectomy: A novel technique for conserving pancreatic tissue. Archives of Surgery, 133, 327–331.PubMedCrossRefGoogle Scholar
- 34.Iacono, C., Bortolasi, L., & Serio, G. (1998). Is there a place for central pancreatectomy in pancreatic surgery? Journal of Gastrointestinal Surgery, 2, 509–517.PubMedCrossRefGoogle Scholar
- 35.Sauvanet, A., Partensky, C., Sastre, B., Gigot, J. F., Fagniez, P. L., Tuech, J. J., et al. (2002). Medial pancreatectomy: A multi-institutional retrospective study of 53 patients by the French Pancreas Club. Surgery, 132, 836–843.PubMedCrossRefGoogle Scholar
- 36.Iacono, C., Bortolasi, L., & Serio, G. (2005). Indications and technique of central pancreatectomy-early and late results. Langenbeck’s Archives of Surgery, 390, 266–271.PubMedCrossRefGoogle Scholar